IBD – Natural approaches to help manage symptoms
World IBD Day on 19th May supports those living with one of these debilitating conditions to come together and raise awareness.
These diseases can have a drastic impact on a person’s quality of life but very few people are aware of the natural and dietary approaches that can make a substantial difference to those living with the condition. I explain what approaches are available and steps you can take to help manage your diagnosis.
About IBD Conditions
Inflammatory Bowel Disease represents two main chronic bowel conditions: Crohn’s and Colitis. It is estimated that over 300,000 people in the UK may have one of these conditions with each condition expected to be lifelong.
There is debate about whether these conditions are truly autoimmune but there is substantial evidence that there is an adverse immune reaction, very often in those genetically predisposed to it.
The main causes of this reaction are thought to be environmental factors. Such triggers are an inappropriate diet, drugs, toxins, infections or invading intestinal microbes (virus and bacteria). And symptoms and disease progression may be made considerably worse by over exposure to chronic stress.
Typical symptoms of IBD conditions are pain, cramping, diarrhoea, frequent bowel movements, bowel urgency, tiredness, fatigue and weight loss. 1 in 2 people may find it affects another part of the body such as bones, skin, eyes, joints, hair, liver.
Some people may wonder about similar IBS (irritable bowel syndrome) symptoms, but whilst IBS can certainly be “irritable” it is not particularly inflammatory or overtly damaging to the gut lining. If unsure visit your GP as a true diagnosis requires in-depth investigation such as colonoscopy and/or CT scan.
What are the Triggers?
Research has shown these conditions are more common in urban rather than rural areas; and in more developed countries especially in the Northern hemisphere. Increasingly younger and younger people are diagnosed. These conditions are increasing in Asian countries and thought to be related to more Western dietary habits and lifestyles. [Thia et al. 2008]
Certain factors jump out at me when I look at the available information and studies:
- Clean environments (the hygiene hypothesis) that means less and less babies and children – and adults too – are exposed to natural bacteria found in soil and on surfaces (this hinders the growth of a wide range of beneficial bacteria that provide natural immune tolerance in the gut);
- A lack of sunshine (vitamin D deficiency is linked to increased risk of auto-immune and/or inflammatory conditions);
- Inflammatory diets consisting of more processed foods (processed fats, higher sugars), higher in gluten and dairy, with a lack of fibre and anti-inflammatory foods. These diets alter the bacterial environment in the gut allowing the promotion of pathogenic bacteria at the expense of beneficial bacteria.
What does a therapeutic diet look like?
In my clinical experience dietary advice provided to sufferers is pretty non-existent other than to eat a diet that is “nutritious and balanced to maintain weight and strength”. So how can an IBD patient choose foods to help manage their condition?
I would initially start with the removal of the potential gut irritants gluten and dairy. This isn‘t part of my standard nutritional advice to clients but in my experience an IBD sufferer is prepared to take the most beneficial dietary steps to help manage symptoms. Dairy and gluten are not essential to the diet. Calcium can be obtained from many other sources and is not essential for strong bones (think Eastern diets where dairy is not consumed at all).
Choose fibrous foods that help with the passage of waste and gently support regular bowel movements without overly irritating the gut wall. This is achieved by avoiding raw salads that are tougher to digest. The last things you want is partially digested foods finding their way down through the colon to irritate it. The same applies to “roughage” (like bran flakes) and woody stems (think kale stems), skins on fruit or potatoes and whole nuts and seeds. More soluble fibre types such as well-cooked porridge (in a nut milk) can be very helpful. Always cook vegetables well as this helps to soften tough plant cell walls.
It is important to rebalance the diet towards anti-inflammatory foods rather than inflammatory types. Really minimise the intake of red meat but do eat fish and eggs for good protein sources.
The problem with most Western diets is there is an imbalance towards pro inflammatory fats rather than anti-inflammatory ones. Be very careful with highly processed Omega 6 vegetable oils (like palm, sunflower, canola, corn). Avoid these at all costs and cook with extra virgin olive oil. Ensure there is a regular intake of oily fish (salmon, mackerel, sardines, trout) three times a week as these fish are rich in anti-inflammatory type fats. Also choose fats from avocados, nut butters and ground flaxseeds.
Further information can be found in the following scientific paper: An Examination of the Diet for the Maintenance of Remission in Inflammatory Bowel Disease (2017)
Are supplements worthwhile?
Vitamin D3 supplementation is essential (usually 1000iu all year round) together with a quality multi vitamin and mineral as nutrient absorption can be affected.
Turmeric is a popular supplement as the active component curcumin provides therapeutic anti-inflammatory benefits that has garnered plenty of attention in recent years particularly for its potential role in IBD conditions.
And last but certainly not least
I always use gold standard stool testing based on DNA technology. It identifies a significant number of important gut markers including levels of inflammation, gut immune response, intestinal permeability, digestive ability, bacterial dysbiosis, pathogenic bacterial overgrowth including toxigenic types and parasites. This test has been highly researched to help deliver the best results for patients. I believe it is a game changer to help identify the true health of the gut and to take steps to help remedy imbalances. The test provides a unique insight and enables the implementation of a truly personalised therapeutic approach.
This advice is not a substitute for professional medical treatment. If you have any concerns particularly any conflict with medical advice or medication, please discuss with your GP.
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Thanks for reading.
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